OECD Health Statistics 2016
Definitions, Sources and Methods
Hospital aggregates: Inpatient care
a) Inpatient care discharges (all hospitals)
An inpatient discharge is the release of a patient who was formally admitted into a hospital for
treatment and/or care and who stayed for a minimum of one night (see definition for hospital
inpatient discharges below). Only the total number of inpatient discharges in all hospitals is
requested (no breakdown by diagnostic categories).
b) Inpatient care average length of stay (ALOS) (all hospitals)
Average length of stay (ALOS) is calculated by dividing the number of bed-days by the number of
discharges during the year (see definition for hospital ALOS below). Only the overall average
length of stay in all hospitals is requested (no breakdown by diagnostic categories).
Sources and Methods
Australia
Source of data:
- Australian Institute of Health and Welfare. Australian hospital statistics. Canberra: AIHW (and previous
issues).
- Data quality statement for AIHW National Hospital Morbidity Database:
http://meteor.aihw.gov.au/content/index.phtml/itemId/529483.
Coverage:
- ALOS: Data represent the number of bed-days divided by number of separations.
- All inpatient data exclude same-day separations.
- Inpatient care covers non same-day separations for public acute care, public psychiatric care, private acute care and
private psychiatric care.
Austria
Source of data: Statistics Austria, Hospital Discharge Statistics.
Coverage:
- Since 1989, ICD-9/KRAZAF-Version.
- From 1997, ICD-9-BMAGS version.
- From 2001, ICD-10 Version 1.3.
- From 2013, ICD-10 BMG 2013.
- From 2014, ICD-10 BMG 2014.
- Day cases are excluded.
- Data do not include any longer the long-term care institutions for the elderly which have not been subject to the
regulations of the Federal Hospital Act during the complete observation period.
Break in time series: DRG-based hospital funding, effective since 1997, might have changed coding performance
relative to the previous years.
Belgium
Source of data: Service Public Fédéral Santé Publique, Sécurité de la chaîne alimentaire et Environnement,
Direction générale de l’Organisation des établissements de soins (Federal Public Service of Health, Food Chain
Safety and Environment), Résumé Clinique Minimum (RCM) (Minimal Clinical Data).
Coverage:
- Inpatient care: All hospital stays (in acute and chronic institutions). It includes all stays with a minimum of one
night and all deaths, including all those who died immediately after hospitalisation.
The following data are to be used with caution:
- Certain general hospitals register newborns as a stay.
- Since 1/7/1996, stays in the psychiatric departments of general hospitals are not included in the RCM database.
Break in time series: The break in 2008 is related to the implementation of new coding rules (some existing rules
have also been re-explained so that the rules are better applied).
Canada
Data not available.
Chile
Discharges
Source of data: Ministry of Health, Department of Statistics and Health Information.
http://deis.minsal.cl/index.asp.
Coverage:
- Data coverage is nationwide.
- Data are collected for both public and private sectors, through a system validated and published by the Department
of Statistics and Health Information (DEIS).
- Hospital discharges are submitted for each establishment on a daily form. The data are collected and validated by
the DEIS.
- The discharges consider public and private sectors. Data include all hospital discharges of patients who died, who
were transferred to other health facilities and those who were discharged to home.
ALOS
Source of data: Ministry of Health (MINSAL), Department of Health Statistics and Information (DEIS).
http://intradeis.minsal.cl/egresoshospitalarios/menu_publica/menu_publica.htm.
Coverage:
- Data coverage is nationwide.
- Data are automatically collected monthly from the health establishments’ information systems and validated and
published by the Department of Health Statistics and Information (DEIS).
- Data correspond to the average length of stay in the public health system and the private sector. They include
deaths, same-day separations and transfers to others institutions in all kinds of hospitals (including long-term care
institutions).
Deviation from the definition: Data include same-day separations.
Czech Republic
Discharges
Source of data: Institute of Health Information and Statistics of the Czech Republic, National Health
Information System (survey on bed resources of health establishments and their utilisation).
Coverage:
- Data refer to number of hospitalisations in general hospitals and specialised therapeutic institutes (excluding
balneologic institutes and convalescence homes for children).
- Hospitalised newborns are excluded.
Deviation from the definition:
- Transfers from one department to another one at the same hospital are considered as two hospitalisations.
- Day cases of patients treated in bed care departments are not excluded.
Break in time series: Until 1999 data cover only establishments of the Health Sector. From 2000 data cover also
health establishments of other central organs.
ALOS
Source of data: Institute of Health Information and Statistics of the Czech Republic, National Health
Information System (survey on bed resources of health establishments and their utilisation).
Coverage:
- Data on inpatient care relate to general hospitals and specialised therapeutic institutes (excluding balneologic
institutes and homes for children).
Deviation from the definition:
- Same-day separations are included in the data.
Denmark
Source of data: National Board of Health, The National Patient Register.
Discharges
Coverage:
- Data includes both somatic and psychiatric hospitals.
Break in time series:
- The data prior to 2005 includes all admissions. The data from 2005 onwards use the 24-hour stay definition, which
explains the lower data values.
- From 2000 onwards, the data no longer include transfer from one department to another department within the
same hospitals.
ALOS
Coverage:
- Psychiatric and somatic hospital departments.
- Nursing homes and private hospitals are not included.
Break in time series:
- ALOS: From 1995, psychiatric hospitals are included.
Estonia
Source of data: National Institute for Health Development, Department of Health Statistics; www.tai.ee
Monthly statistical report “Hospital beds and hospitalisation.”
http://pxweb.tai.ee/esf/pxweb2008/Database_en/HCresources/02HospitalBeds/01LT/RVinfo_en.htm.
Coverage:
- All institutions providing in-patient care.
- In Estonia, due to the restructuration of health care services, the hospitals that provided only in-patient long-term
care services (long-term care hospitals) were reorganised to the nursing care hospitals. This change came into force
in the beginning of 2013. According to the SHA2011, these nursing care hospitals do not belong to H.P.1 and
previous long-term care hospitals are classified as long-term nursing care facilities (H.P.2 in SHA2011). Therefore,
the number of hospitals (H.P.1 coded on the basis of SHA2011) decreased in 2013 as well as all other statistics
provided for in-patient care (all hospital beds, all discharges by hospital beds). This change does not have an impact
on statistics about curative care.
- Day cases are not included.
- All beds are included.
- ALOS is calculated as the number of stayed days divided by the number of discharges.
Deviation from the definition:
- Data for 1980 and for 1985-2002 represent the figures for hospital admissions.
- Data for 2003-2011 have been changed, i.e. figures of the discharges are presented. (Data for the years before 2003
were not available for recalculations).
Notes:
- The figures of the discharges based on hospital beds utilisation differentiate from the figures of the discharges by
diagnoses in the case of Estonia. Discharges by the hospital beds include three categories of patients: those who left
the hospitals, the deceased and those who transferred to another hospital. Healthy newborns are excluded and also ill
newborns are excluded in case they are not transferred from the maternity ward to another department. Discharges
with Z03 are included.
- Discharges by diagnostic categories include all ill newborns irrespective of their bed profile or department, but do
not include patients transferred to another hospital (discharges and bed days from the last hospital are included –
approximately 5% discharges and bed days are lost). Patients with diagnoses Z03 and healthy newborns are
excluded.
Finland
Source of data: National Institute for Health and Welfare (THL), Care Register for Institutional Health Care.
Break in time series: The data follows SHA 2011 manual since 2000. Before 2000, inpatient care discharges
included transfers to other units within the same hospitals.
France
Source of data:
- SAE file (Statistique annuelle des établissements de santé/Annual statistics of health institutions) managed by
Drees (Direction de la recherche, des études, de l’évaluation et des statistiques) from the Ministère du Travail, de
l’Emploi et de la Santé (Secteur Santé). http://www.sae-diffusion.sante.gouv.fr/Collecte_2011/.
Coverage:
- Data refer to inpatients in public and private health establishments (staying more than 24 hours) in France
(metropolitan France and D.O.M.). Data include residents of France (metropolitan France and D.O.M.) (residents of
foreign countries and T.O.M. are excluded except in 1997) and include newborns staying with their mother.
- Inpatient care discharges: total number of admissions in all services (short-term, rehabilitation care, psychiatric
care and long-term care) in all hospitals.
- Inpatient care ALOS: total number of days carried out in all services (short-term, rehabilitation care, psychiatric
care and long-term care) in all hospitals, applied to the total number of admissions in all hospitals for the year
considered.
Break in time series:
- Break in series in 2003: for curative care use of National databases from the "programme de médicalisation des
systèmes d'information (PMSI)". See details at “hospital discharges by diagnostic categories”. See the annual report
“Panorama des établissements de santé : L’activité en hospitalisation complète et partielle”,
http://www.drees.sante.gouv.fr/le-panorama-des-etablissements-de-sante,1186.html.
Germany
2003-2014:
Source of data: Federal Statistical Office, Hospital statistics (diagnostic data of the hospital patients and patients of
prevention or rehabilitation facilities); Statistisches Bundesamt, Fachserie 12, Reihe 6.2.1 and ibid, Fachserie 12,
Reihe 6.2.2 and special calculations by the Federal Statistical Office.
See http://www.destatis.de or http://www.gbe-bund.de.
Reference period: During the year.
Coverage:
- An inpatient discharge is the release of a patient who was formally admitted into a hospital for treatment and who
stayed for a minimum of one night. The number of discharges includes deaths in hospital, but excludes same-day
separations and transfers to other care units within the same institution. Day cases are excluded.
- ALOS is calculated by dividing the number of bed-days by the number of discharges.
- Coverage by hospital type: Data include discharges during a given calendar year from all types of hospitals
(HP.1.1, 1.2 and 1.3) in all sectors (public, non-profit and private). Included are discharges from general hospitals,
mental health hospitals and prevention and rehabilitation facilities. Long-term nursing care facilities are excluded.
- Missing records: Discharges from prevention and rehabilitation facilities with 100 or less than 100 beds are not
included (about 14% of all patients in rehabilitation centres).
- Other notes related to coverage: The number of discharges includes patients with unknown diagnosis, age and/or
sex.
Additional information:
- In German health statistics publications, the number of discharges includes the number of inpatient cases as well as
the number of day cases. Therefore the total number of cases in these publications is higher.
- Furthermore, for each day case one bed-day is calculated. Since the average length of stay (ALOS) is the quotient
of bed-days and discharges, the ALOS in these publications is lower than when calculated on the basis of only
inpatients and bed-days for inpatients.
1970-2002:
Source of data: Federal Statistical Office, Hospital statistics (basic data of hospitals & prevention or rehabilitation
facilities); Statistisches Bundesamt, Fachserie 12, Reihe 6.1, table 1.1.
See http://www.destatis.de or http://www.gbe-bund.de.
Coverage:
- The number of cases is equal to the sum of admissions plus the discharges including deaths divided by 2.
- ALOS is calculated by dividing the bed-days by the number of cases.
- Coverage by hospital type: Data include cases in all types of hospitals (HP.1.1, 1.2 and 1.3) in all sectors (public,
not-for-profit and private). Included are cases in general hospitals, mental health hospitals and prevention and
rehabilitation facilities. Long-term nursing care facilities are excluded.
Deviation from the definition:
- In reporting year 2002, the number of cases includes additionally day cases (patients admitted for a medical
procedure or surgery in the morning and released before the evening).
Additional information:
- In German health statistics publications, the number of cases includes the number of inpatient cases as well as the
number of day cases. Therefore the total number of cases in these publications is higher.
- Furthermore, for each day case one bed-day is calculated. Since the average length of stay (ALOS) is the quotient
of bed-days and cases, the ALOS in these publications is lower than when calculated on the basis of only inpatients
and bed-days for inpatients.
Break in time series: 2003 (change in source and method).
Greece
Source of data: Hellenic Statistical Authority, Division of Social Welfare and Health Statistics.
Coverage:
- ALOS: Average length of stay for inpatient care is estimated by dividing the total number of days stayed by the
total number of discharges (in public and private hospitals), including deaths.
- Same-day separations are excluded.
- Patients suffering from schizophrenia with an average length of stay > 365 days are excluded.
Hungary
Source of data:
- From 2004 onwards: National Institute for Strategic Health Research (ESKI).
- Until 2003: Center for Health Care Information (GYOGYINFOK). http://www.gyogyinfok.hu.
Coverage:
- From 2004 onwards:
- Discharges: Data are the case number of hospital discharges, rather than the case number of department
discharges. Same day discharges are excluded.
- ALOS: Average length of stay at hospitals.
- Until 2003: Discharge data are the case number of department discharges.
Break in time series: From 2004 onwards, ESKI processes the data in the itemised inpatient financing report. Data
are calculated by case number for hospital discharge, not case number for department.
Iceland
Source of data: The Directorate of Health / The Ministry of Health and Social Security.
Coverage: Data from 1999 and onwards has been revised according to the definition below:
- Data cover the whole country.
- Data cover the public sector (all hospitals in Iceland are publically financed).
- Data from 1999-2006 cover health care facilities with at least one bed available for curative care.
Break in series as of 2007: Data have been updated back to 2007 so that the data now more accurately match the
definition of hospitals given in the joint questionnaire (facilities where there is not a 24 hour physician presence are
excluded).
Included:
All discharges with LOS less than 90 days.
- Discharges where diagnosis is missing or ICD10 code is invalid.
- Newborns.
- Only hospitals with a 24 hour physician presence (from 2007 and onwards).
- Transfers to other specialty areas (“þjónustuflokkar”) within hospitals are included.
- Day care cases were included to some extent from 1985-1988.
Ireland
Source of data:
- From 2006: Health Service Executive and Health Research Board.
- Up to 2005: Department of Health & Children.
Coverage:
- Discharges: Figures refer to the number of inpatients, excluding day cases, who were discharged from or died in
publicly funded acute and psychiatric (public and private) hospitals.
- ALOS: The number of bed-days used divided by the number of inpatients discharged (including deaths, excluding
day cases). The inpatient ALOS refers to all specialties, regardless of length of stay, in HSE Network acute public
hospitals, public and private psychiatric hospitals. Beds in private acute hospitals are not included.
Breaks in time series:
- Since 2004: Public and private psychiatric hospitals are included.
- Since 2009: Public acute hospitals and public and private psychiatric hospitals only (ie HP.1 - Hospitals) are
included. Up to 2008, district and community hospitals (which may be defined as HP.2 facilities) were also
included.
Deviation from Definition: a small number of discharges from psychiatric hospitals/units which do not strictly meet
the definition of a HP1 hospital are included in the data.
Israel
Source of data: Health Information Division, Ministry of Health. The data are based on the following databases:
(a) The National Hospital Discharge Database, maintained by Health Information Division in the
Ministry of Health. It includes most acute care hospitals as well as some special hospitals.
(b) The Inpatient Mental Health Database, maintained by the Department of Mental Health in the
Ministry of Health. It includes all inpatient hospitalisations in mental health departments in all hospitals.
(c) Summary Hospitalisation Database, with information that is collected routinely by the Health
Information Division in the Ministry of Health. It includes all admissions to all inpatient institutions,
hospitals (HP.1) and nursing care (HP.2) by wards, year and month, but does not include data on diagnoses,
procedures, age, gender or admissions and discharges dates.
Coverage: The data include all acute care hospitals, mental health hospitals and special hospitals. Patients who were
admitted and discharged on the same date from hospitalisation wards were defined as day cases and excluded.
Healthy newborns were included. Geriatrics nursing care, Mentally frail and Complex nursing care departments in
hospitals were included.
- In 2001, two psychiatric care hospitals were closed and that caused a decrease in inpatient ALOS.
- In 2006, a number of mental health beds were cancelled, and many mental health patients (who usually tend to
have long length of stay) were “discharged” towards other facilities. This led to an artificial spike in ALOS in 2006.
Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities.
The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli
settlements in the West Bank under the terms of international law.
Italy
Source of data:
- From 1996 onwards: The data source is the Ministry of Health and the title of the publication is “Rapporto
annuale sull’attività di ricovero ospedaliero – Dati SDO” available on the web site of the Ministry of Health at
http://www.salute.gov.it/portale/temi/p2_6.jsp?lingua=italiano&id=1237&area=ricoveriOspedalieri&menu=vuoto.
Scheda di Dimissione Ospedaliera (SDO) is the full original title of the National Hospital Discharge Data Base
(NHDDB). More information about SDO can be found at
http://www.salute.gov.it/portale/temi/p2_4.jsp?lingua=italiano&tema=Assistenzaospedaleeterritorio&area=ricoveri
Ospedalieri.
- Until 1995: a sample survey was run by ISTAT (National Institute of Statistics).
Coverage:
- The NHDDB (SDO) covers the entire Country, both public and private hospitals (HP.1.1 and HP.1.3 excluding
army hospitals). The NHDDB has gradually improved in quality and completeness during the first five years,
starting from 1995-1996.
- Inpatient care discharges include all patients admitted in hospital for treatment and/or care and who stayed in
hospital at least for one night. Hospital treatment and care include curative care, rehabilitative and long-term care
post illness or injury.
- Average length of stay (ALOS) is calculated by dividing the number of bed-days by the number of discharges
during the year.
Break in time series: 1996.
- There is a break in the time series due to the different sources: firstly the sample survey run by Istat and then the
total survey (SDO) run on the total Hospitals.
Japan
Source of data: Ministry of Health, Labour and Welfare, Hospital Report (published annually).
Coverage:
- The data were collected from medical institutions with inpatient facilities for 20 or more patients, which are called
hospitals in Japan, and do not include medical clinics with no inpatient facilities or with inpatient facilities for 19 or
fewer patients.
- Average length of stay: Annual total number of inpatients divided by [(the number of newly admitted patients that
year plus the number of discharged patients that year) multiplied by 1/2].
- Due to the Great East Japan Earthquake, the report of March 2011 for the following 11 hospitals tabulated only the
number of patients they reported: 1 institution of Kesen medical area of Iwate Prefecture, 1 institution of Miyako
medical area of Iwate Prefecture, 2 institutions of Ishinomaki medical area of Miyagi Prefecture, 2 institutions of
Kesennuma medical area of Miyagi Prefecture, and 5 institutions of Soma medical area of Fukushima Prefecture.
Deviation from definition:
- The data include same-day separations.
Korea
Inpatient care discharges
Source of data: Ministry of Health and Welfare, Korea Institute for Health and Social Affairs, The Patient
Survey Report.
Coverage:
- The Patient Survey had been conducted every 3 years until 2005. It has been changed to annual survey in 2008.
- The data includes hospital discharges only (hospital is defined as medical institutions equipped with 30 beds or
more in Korea). Discharges which occurred in medical institutions other than hospitals (such as doctor’s offices and
clinics) are excluded.
Inpatient care ALOS
Source of data: Ministry of Health and Welfare, Korea Institute for Health and Social Affairs, The Patient
Survey Report.
Coverage:
- The Patient Survey had been conducted every 3 years until 2005. It has been changed to annual survey in 2008.
- The data includes hospital ALOS only (hospital defined as medical institutions which have more than 30 beds in
Korea). Inpatients in medical institutions other than hospitals (such as doctor’s offices and clinics) are excluded.
Latvia
Source of data: Centre for Disease Prevention and Control.
Coverage: Hospital discharges including patients who returned home, were transferred to another hospital or died.
Luxembourg
Source of data: Fichiers de la sécurité sociale. Data prepared by Inspection générale de la sécurité sociale.
Coverage:
Discharges and ALOS
- All budgeted hospitals have been taken into account to calculate rates (including mid-term and long-term
psychiatric rehabilitation centres, functional rehabilitation centres and a specialised establishment for palliative care
existing since 2011).
- Data refer to the insured resident population.
- Admissions from the subchapters V, W, X and Y from ICD-10 are excluded.
- Healthy new-born babies are not registered as patients by hospitals. Therefore, no diagnostic for discharge is
provided.
- Data for 2013 and 2014 should be considered as preliminary.
Mexico
Source of data:
- Ministry of Health, Bulletin of Statistical Information. National Health Care System, Vol II, “Health Damages”.
1995-2003.
- Ministry of Health, Hospital aggregates database 2004-2014.
Further information: http://dgis.salud.gob.mx/cubos/.
Coverage:
- Data include information from public institutions: Ministry of Health (SS), Social Security Institute (IMSS), Labor
Social Security Institute (ISSSTE), Ministry of Navy (SEMAR), Ministry of War (SEDENA) (until 2004) and
Mexican Petroleum (PEMEX). Data do not include information of private hospitals, state (local) hospitals,
university hospitals and Red Cross.
- Includes all types of hospital care.
Break in time series: 2014. From 2014, data from the IMSS (the largest health care provider) include discharges
from ambulatory beds (in addition to discharges from in-stay beds).
Netherlands
Discharges
Source of data: Statistics Netherlands, Statistics of intramural health care; National Medical Registration.
Coverage: The data cover all admissions for 24-hour care in general, university and specialized hospitals as well as
mental hospitals. Excluded are all babies born in hospitals.
Break in time series: 2002 and later includes healthy new born infants, if mother was an inpatient.
ALOS
Source of data: Statistics of Intramural Health Care; National Medical Registration.
Coverage:
- Same-day separations are excluded in the calculation.
- Bed-days of newborns are excluded in the calculation up to 2006.
New Zealand
Source of data: Data extracted from the National Minimum Data Set (NMDS), maintained by the Ministry of
Health (National Collections & Reporting - NCR).
Coverage:
- The data currently exclude same-day separations.
- The hospital aggregates data exclude Short Stay ED. (Short Stay ED events are defined as discharges with an
emergency department health specialty code and a length of stay equal to 0-days or 1-day. These are typically
excluded for analysis and reporting purposes because they have been inconsistently reported over time).
- Publicly-funded hospital discharges with a Length of Stay > 0. No further filters were applied.
- Private hospital stays that were publicly funded are included; excluded otherwise.
- There is a time lag with reporting some of the data to the National Minimum Data Set (NMDS) which will lead to
revised data.
- No new data for 2014 could be provided due to the provisional nature of the data. Data for 2014 will be provided
next year, after provisional estimates have been revised and data more accurately reflect the hospital care for 2014.
Break in time series: 2000. In 2016, the data have been revised back to 2000 to better fit the definition.
Norway
Source of Data: Statistics Norway, https://www.ssb.no/en/helse/statistikker/speshelse.
- Administrative register: The Norwegian Patient Register administered by The Norwegian Directorate of Health.
The Norwegian Patient Register includes all data on the hospital activities.
Coverage:
- Day separations are included and counted as one bed-day.
- ALOS: Number of bed-days divided by number of discharges, including deceased.
- Private rehabilitation institutions included in the statistics for the first time in 2000.
Break in time series: 2009. All hospitals included from 2009.
Poland
Discharges
Source of data:
- Up to 2004: Ministry of Health collected aggregated information about inpatients in the hospitals.
- From 2005 onwards:
- National Institute of Public Health-National Institute of Hygiene (NIPH-NIH), General Hospital
Morbidity Study (GHMS), for discharges from general (i.e. non-psychiatric) hospitals.
- Institute of Psychiatry and Neurology, Psychiatric Inpatient Morbidity Study (PIMS), for discharges from
psychiatric hospitals and psychiatric departments of general hospitals.
Break in time series: 2005 due to change in the source.
ALOS
Source of data:
- National Institute of Public Health-National Institute of Hygiene (NIPH-NIH), General Hospital Morbidity
Study (GHMS), for discharges from general (i.e. non-psychiatric) hospitals.
- Institute of Psychiatry and Neurology, Psychiatric Inpatient Morbidity Study (PIMS), for discharges from
psychiatric hospitals and psychiatric departments of general hospitals.
Coverage:
- Day cases are excluded.
- The inpatient average length of stay is calculated by dividing number of beddays by inpatients in all general and
specialised hospitals (public and private hospitals, army hospitals, psychiatric hospitals and health resort
(sanatorium) hospitals).
Portugal
Source of data: National Statistical Institute, annual questionnaire, to all hospitals (public and private hospitals).
Coverage:
- National coverage.
- All hospitals (public and private sector) are covered.
- ALOS: Number of bed-days divided by number of discharges including deaths.
Slovak Republic
Source of data: National Health Information Center (NHIC).
- Data up to 2008: Annual report L (MZ SR) 1 - 01 on bed fund of health facility.
- Data for 2009-2011: Annual report P (MZ SR) 1 - 01 on bed fund of health facility.
- Data from 2012: Report on admission of inpatient care Z (MZ SR) 1 – 12.
Coverage:
- Data are gathered from hospitals and special health institutes, excluding independent hospices, newborn cots and
dialyses points.
Deviation from the definition:
- Same-day separations (i.e. day cases) and transfers to other care units within the same institution are included until
2011.
- From 2012, transfers to other care units within the same institution are not included. Same-day separations, i.e. day
cases, are included.
Slovenia
Source of data:
- Up to 2010: National Institute of Public Health, Slovenia. Treating Institution Report.
- From 2011: National Institute of Public Health, Slovenia, National Hospital Health Care Statistics Database.
Coverage:
- Up to 2010
- ALOS: Number of beddays divided by the number of admissions.
- Admissions (remaining from the previous year and new admissions) in general hospitals, clinics and
special hospitals (public and private) are included.
- From 2011:
- ALOS: Average length of stay is calculated by dividing the total number of in-patient days by the
number of discharges. Number of days equals date of discharge minus date of admission.
- Discharges in general and university, psychiatric and specialty hospitals (public and private) are
included.
Breaks in time series:
- 2011 due to change in the source.
- From 2013: joint in-patient data capture.
Spain
Source of data: Ministerio de Sanidad, Política Social e Igualdad (Ministry of Health, Social Services and
Equality) and Instituto Nacional de Estadística (National Statistical Institute).
http://www.msssi.gob.es/estadEstudios/estadisticas/estHospiInternado/inforAnual/homeESCRI.htm.
- Up to 2009: data are issued from Estadística de Establecimientos Sanitarios con Régimen de Internado (Statistics
on Health Establishments Providing Inpatient Care).
- From 2010: data are issued from Estadística de centros de Atención Especializada (National Statistics on
Specialised Centres).
Coverage:
- All private and public hospitals are included.
- Data are calculated from national hospital statistics where hospitals are classified with the following categories:
General hospital (1.1)
Specialised hospital (1.2)
Mental Health hospital (1.3)
Long term care hospital (1.4)
Data include all types of hospital.
Sweden
Source of data: National Board of Health and Welfare, National Patient Register (NPR).
Coverage:
- National Patient Register (NPR). The National Patient Register started in 1964. Since 1987, the register has
covered public in-patient care. During the years 1987–1996, the Swedish version of WHO's International
Classification of Diseases (9th revision) was used. ICD10 was introduced in 1997. The number of dropouts in the
register reporting is estimated to be between one and two percent.
- In 2014, the data series has been revised from 1998 onwards. It now contains only patients who stay overnight in
hospital care.
Break in time series: 1998.
Switzerland
Source of data:
- Data since 1997: Federal Statistical Office, Neuchâtel. Hospital Statistics, yearly census.
- Data prior to 1997: Association des Hôpitaux (H+).
Coverage:
- Full coverage of hospitals.
- Day cases are excluded.
Break in time series:
- 2009: Until 2008, healthy newborns were excluded.
- 2010: New concept for the Hospital Statistics.
Turkey
Source of data: General Directorate for Health Services, Ministry of Health.
Coverage:
- MoH hospitals, university hospitals, private hospitals and others included.
- Hospitals affiliated with the Ministry of National Defence are not included.
- Discharges: Newborns are included. V, W, X and Y codes have been excluded from the grand total since 2010.
Before 2010 V, W, X and Y codes cannot be distinguished.
- ALOS: Average length of stay calculated for acute and long-term care hospitals.
Break in time series: From 2011 onwards, data are provided from the DRG database. They refer to inpatient cases
only and include healthy new-born babies.
Note: In 1999, an earthquake occurred with the magnitude 7.4, causing many deaths and injuries. This explains the
high ALOS in 1999.
United Kingdom
Discharges
Source of data:
- England: Health & Social Care Information Centre (HSCIC).
- Scotland: NHS National Services Scotland, Information Services Division (ISD).
- Wales: NHS Wales Informatics Service (NWIS), Patient Episode Database.
- Northern Ireland: Department for Health, Social Services and Public Safety, KH03.
Coverage:
- Data relates to NHS discharges or NHS commissioned activity in the independent sector. Data may not be
complete as further submissions may be received at a later date. Figures are based on completed hospital spells &
diagnosis at discharge, with the exception of Scottish maternity data which is episode based.
- Wales - Data is based on the criteria where patient stayed at least one night in the hospital (admission date <>
discharge date – inpatients only). Data is based on financial discharge year. The numbers are based on discharges
(max episode in spell). Data is based on Welsh providers only. Wales data now includes all discharges, regardless of
whether a discharge has a diagnosis.
- Scotland (2016) restated data from 2001 to 2013. Data changed to financial year to match England and Wales.
- England data for Hospital Aggregates have been restated in 2014 since 2000. Previously a small number of records
were being double counted in the number of discharges and therefore being used in the denominator for length of
stay, which has resulted in a change in the figures.
Break in time series: Data from 2000 onwards is not comparable with data from prior to this. This is due to work
conducted to improve compliance with definitions and consistency of methodologies across the four parts of the UK.
ALOS
Source of data: Calculated by Health & Social Care Information Centre (HSCIC) for the UK using data from:
- England: Health & Social Care Information Centre (HSCIC) (http://www.hscic.gov.uk) - Hospital Episode
Statistics (HES).
- Scotland: NHS National Services Scotland, Information Services Division (ISD)
(http://www.isdscotland.org/Health-Topics/Hospital-Care/Data_Sources_and_Clinical_Coding.doc) - Scottish
Morbidity Record Schemes SMR01, which records all inpatient and day-case discharges from non-obstetric and
non-psychiatric specialties in NHS hospitals in Scotland; SMR02, which records all obstetric discharges; and
SMR04, Psychiatric Hospital Records. For obstetric data, numbers and length of stay recorded on SMR02 have
been combined with records on SMR01.
- Wales: NHS Wales Informatics Service (NWIS). http://www.statswales.wales.gov.uk/index.htm - Patient
Episode Database for Wales (PEDW).
- Northern Ireland: The Department for Health, Social Services and Public Safety in Northern Ireland
(DHSSPSNI). http://www.dhsspsni.gov.uk/hospital-activity - Hospital Inpatient System (HIS).
Coverage:
- Data cover the UK National Health Service (NHS) only.
- England data for Hospital Aggregates have been restated in 2014 since 2000. Previously a small number of records
were being double counted in the number of discharges and therefore being used in the denominator for length of
stay, which has resulted in a change in the figures.
- Discharge data may not be complete, as submissions may be received at a later date.
- Data exclude day cases.
- In Wales, based on Welsh providers, only inpatients are included, day cases are excluded.
- In Northern Ireland, length of stay is calculated by subtracting admission date from discharge date (in days). Day
cases are those admissions where length of stay is equal to 0. Regular night admissions are therefore not classified as
day cases and are included.
- Data for England, Wales and Scotland are by financial year. Data for Northern Ireland are by calendar year.
United States
Average length of stay
Source of data: American Hospital Association (AHA)/Annual Survey of Hospitals database/AHA Hospital
Statistics for the relevant years. Unpublished data. http://www.ahadata.com/ahadata_app/index.jsp.
Coverage:
- Defined as total facility inpatient days divided by the total facility number of admissions.
Deviation from the definition: Data match the OECD definition.
- AHA-registered and non-registered hospitals in the United States. U.S. hospitals located outside the United States
are excluded.
Estimation method:
- US estimates come from short-term general hospitals.
- Short-term general hospitals, as defined by the AHA, are hospitals that may provide either non-specialised or
specialised care, with the majority of their patients staying for fewer than 30 days.
Estimation method: Survey.
Break in time series: No breaks in time series.
NON-OECD ECONOMIES
Brazil
a) Inpatient care discharges (all hospitals)
Source: Ministério da Saúde/SE/Datasus - Sistema de Informações Ambulatoriais do SUS (SIA/SUS).
Methodology: The number of admissions does not include admissions only during the day.
Further information: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?idb2012/f03.def.
b) Inpatient care average length of stay (ALOS) (all hospitals)
No data available.
c) Curative (acute) care average length of stay (ALOS)
No data available.
China
a) Inpatient care discharges (all hospitals)
Source: Ministry of Health. China Health Statistics Yearbook 2015.
Public Health and Social Services > 22-11 Hospitalization Services in Health Institutions by Region.
Further information: http://www.stats.gov.cn/tjsj/ndsj/2015/indexeh.htm.
b) Inpatient care average length of stay (ALOS) (all hospitals)
Source: Ministry of Health. China Health Statistics Yearbook 2015.
Public Health and Social Services > 22-5 Number of Visits and Inpatients in Medical Institutions and Utilization of
Beds.
Further information: http://www.stats.gov.cn/tjsj/ndsj/2015/indexeh.htm.
c) Curative (acute) care average length of stay (ALOS)
Data not available.
Colombia
a) Inpatient care discharges (all hospitals)
Source: Individual Register of Service Providers (RIPS), Ministry of health and social protection.
Coverage: National.
- The collection of the RIPS data started in 2009. Therefore, there is no information available before 2009.
b) Inpatient care average length of stay (ALOS) (all hospitals)
Source: Individual Register of Service Providers (RIPS), Ministry of health and social protection.
Coverage: National.
- The recollection of the RIPS data started in 2009. Therefore, there is no information available before 2009.
c) Curative (acute) care average length of stay (ALOS)
Data not available.
India
a) Inpatient care discharges (all hospitals)
Data not available.
b) Inpatient care average length of stay (ALOS) (all hospitals)
Data not available.
c) Curative (acute) care average length of stay (ALOS)
Data not available.
Indonesia
a) Inpatient care discharges (all hospitals)
Data not available.
b) Inpatient care average length of stay (ALOS) (all hospitals)
Data not available.
c) Curative (acute) care average length of stay (ALOS)
Data not available.
Lithuania
Source of data:
- From 2001: HI HIC data from annual reports and Compulsory Health Insurance Database (for day cases). Report
“Health Statistics of Lithuania”, available from http://www.hi.lt/lt/lietuvos-sveikatos-statistika-health-statistics-oflithuania.html.
- Up to 2000: LHIC, annual report data.
Coverage:
- From 2001: Discharge data excluding nursing patients, day cases, including healthy newborns. As some budget
financed and some private hospitals do not present discharge data for Compulsory Health Insurance Database, this
data could not be presented in record structure. Therefore the number of discharges in record structure is less than
the number of discharges in hospital aggregates table.
- Up to 2000: discharge data excluded healthy newborns, including day cases.
Russian Federation
a) Inpatient care discharges (all hospitals)
Sources:
From 2012: Federal States Statistical Services (ROSSTAT), Form of Federal Statistical Survey № 1-zdrav
«Information on organizations providing health services to population (including data of the Ministry of Health of
the RF on the number of doctor consultations, Form No 47 “Information on the network and activities of health care
institutions”.
Until 2011: World Health Organization Europe - European health for all database (HFA-DB). Data refer to the
number of hospital admissions (without day cases).
b) Inpatient care average length of stay (ALOS) (all hospitals)
Sources:
2014: Ministry of Health of the Russian Federation, Form No 47 approved by ROSSTAT “Information on the
network and activities of health care institutions”.
From 2012: Federal States Statistical Services (ROSSTAT), Form of Federal Statistical Survey № 1-zdrav
«Information on organizations providing health services to population (including data of the Ministry of Health of
the RF on the number of doctor consultations, Form No 14 “Information on the activities of health care institutions
providing health care services in hospitals”.
Until 2011: World Health Organization Europe - European health for all database (HFA-DB).
c) Curative (acute) care average length of stay (ALOS)
Sources:
2012: Federal State Statistical Service (ROSSTAT).
Until 2006: World Health Organization Europe - European health for all database (HFA-DB).
South Africa
a) Inpatient care discharges (all hospitals)
Data not available.
b) Inpatient care average length of stay (ALOS) (all hospitals)
Source: District Health Information System Database (DHIS), National Department of Health.
Methodology:
- Data refer to average duration of patient stay in health facility.
- Numerator: Inpatient days + 1/2 Day patients
- Denominator: Inpatient separations (currently defined as: Discharges + Deaths + Transfers out)
- Data may be given for financial years rather than calendar years. Data for 2014 is for the 2014/15 financial year
Further information: http://indicators.hst.org.za/healthstats/157/data.
c) Curative (acute) care average length of stay (ALOS)
Data not available.
© OECD, OECD Health Statistics 2016. June 2016.
http://www.oecd.org/health/health-data.htm